Consolidation durvalumab improved overall survival (OS) in locally advanced non-small cell lung cancer (LA-NSCLC) treated with chemoradiotherapy (CRT) in the PACIFIC trial; however, pneumonitis was increased with durvalumab. We sought to examine real-world outcomes with the PACIFIC paradigm, especially factors associated with pneumonitis, using a multi-institutional review.
Patients with LA-NSCLC treated with CRT followed by durvalumab from January 2017-February 2019 were identified at 2 institutions. We characterized demographics, tumor factors, radiotherapy, and duration of durvalumab. We examined pneumonitis outcomes including re-challenge success, with secondary endpoints of progression-free survival (PFS) and OS.
Thirty-four patients were included with median follow-up of 12 months (range, 3 to 20 months); 94% had stage III disease. The cumulative grade &gt;2 pneumonitis rate was 26.5% with 2 patients developing grade 3 pneumonitis and no grade 4/5 events. Median time to pneumonitis after RT was 2.monitis. In this small case series, pneumonitis did not appear to negatively impact survival, and durvalumab re-challenge appeared feasible after pneumonitis treatment with steroids.Complete resection is a standard treatment for patients with Masaoka-Koga stages II and III thymoma, however the role of postoperative radiotherapy (PORT) is controversial. We analyzed data collected from 4 Korean hospitals to determine the effectiveness of PORT in stage II and III thymoma patients.
Between January 2000 and December 2013, 1,663 patients underwent surgery for thymic tumors at the 4 hospitals. Among them, 668 patients (527 with stage II and 141 with stage III) were investigated, among whom, 443 received PORT (335 with stage II and 108 with stage III). Propensity score matching (PSM) was performed, and 404 patients (346 with stage II and 58 with stage III) were selected.
Perioperative characteristics were similar in the PORT and non-PORT groups after PSM. On survival analysis of stage II patients, the PORT and non-PORT groups showed no difference in either 5-year recurrence-free survival (RFS) (96.3% 96.6%, P=0.622) or 5-year overall survival (OS) (94.6% 93.8%, P=0.839). However, among stage III patients, the PORT group showed significantly better 5-year RFS (75.7% 50.1%, P=0.040) and 5-year OS (86.5% 54.7%, P=0.001). On multivariate Cox regression analysis, PORT was a significant positive prognostic factor in terms of both RFS (P=0.005) and OS (P=0.004) in patients with stage III thymomas, but not in those with stage II disease (P=0.987 and 0.968, respectively).
PORT improved the RFS and OS in stage III thymoma patients, but showed no survival benefit in stage II patients.
PORT improved the RFS and OS in stage III thymoma patients, but showed no survival benefit in stage II patients.The objective of this retrospective study is to evaluate the impact of the CCI on short-term outcomes in pulmonary resection.
We retrospectively analyzed 1,309 patients who underwent pulmonary surgery consecutively in our hospital.
All patients were divided into complication group and non-complication group. CCI (P=0.012), blood loss (P=0.015) and type of surgery (P&lt;0.001) were an independent risk factors for complications in multivariate analysis. Assuming a threshold of 3 for defining poor outcomes for pulmonary resection, the sensitivity and specificity were 87.9% and 44.2%, respectively. The area under the curve for CCI was 0.711 (P&lt;0.001). There were 918 (70.1%) patients in the CCI ?3 group and 391 (29.9%) patients in the CCI ?3 group. The rate of poor outcome was 3.3% in the CCI ?3 group, and 9.2% in the CCI &gt;3 group (P&lt;0.001).
The main finding of the present study was that CCI &gt;3 was associated with a poor short-term outcome. For patients with CCI &gt;3, it was suggested that the experienced surgical team should perform pulmonary resection in the shortest time and preserving the lung function as much as possible.
3, it was suggested that the experienced surgical team should perform pulmonary resection in the shortest time and preserving the lung function as much as possible.The pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) creates many challenges for the healthcare sector. Currently, little is known of how the pandemic has impacted patients with cardiovascular disease. https://www.selleckchem.com/products/pf-06650833.html The primary focus of this study was to determine whether emergency cardiovascular surgeries can be carried out safely during the COVID-19 pandemic.
Between 17 January 2020 and 11 February 2020, 13 patients were admitted to Wuhan Union Hospital for emergency cardiovascular surgery. During this time, Wuhan was a COVID-19 epicenter, and Wuhan Union Hospital is a sentinel hospital located in this area. These patients' epidemiological histories, clinical records, laboratory assessments, imaging findings, and surgical outcomes were retrospectively reviewed. Throat swabs were collected from some patients preoperatively and all patients postoperatively for reverse transcription polymerase chain reaction (RT-PCR) testing to determine whether these patients had COVID-19.
This cohort includy patients with acute and severe cardiovascular disease, regardless of the pandemic. Our study indicates that, with adequate preparation and the provision of appropriate treatment, satisfactory outcomes can be achieved for such patients.Various radiological tools have been introduced to determine the malignancy or prognosis of lung carcinomas. We retrospectively summarized the clinical outcomes to evaluate whether radiological tools such as consolidation-to-tumor ratio (CTR), tumor disappearance ratio (TDR), and mediastinal diameter (MD) are suitable for surgically resected non-small-cell lung cancer (NSCLC).
This retrospective study included 260 patients (128 men and 132 women; median age, 64 years) with cT1N0-staged NSCLC who underwent thoracotomy. Disease-free survival (DFS) and overall survival (OS) outcomes were analyzed using the Kaplan-Meier method and Cox proportional hazards model.
When the adjusted hazard ratios (HRs) with reference to cT1a/1 mi were calculated, significant differences were observed in cT1b and cT1c for DFS (P=0.04 and P&lt;0.01, respectively) and in cT1c for OS (P=0.01). For HRs with reference to CTR (?0.5), a significant difference was only observed in CTR (&gt;0.5) for DFS (P=0.01). For HRs with reference to TDR (?25%), significant differences were observed in TDR (&gt;75%) for DFS (P=0.